asco-logo Every month or two I see a patient, usually a man with prostate cancer, who is concerned that if he has intercourse with his spouse, he will give her cancer. The question is asked with sincerity, and I can see the worry in the man’s eyes. His spouse is often equally worried but she often looks embarrassed too, almost as ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated in follow-up after a recent routine screening for antibody to hepatitis C virus (HCV) was positive. His medical history is unremarkable; he has not used illicit drugs or had any history of blood transfusions. He currently feels well and takes no medications. Vital signs and physical examination are ...

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Although it is still early, 2016 is already shaping up to be a year to remember in science: Long-postulated gravitational waves were finally discovered, the CDC scrambles to battle Zika virus on multiple continents, and long-awaited clinical testing begins for a new HIV vaccine. But these accomplishments all pale in comparison to the monumental study published in the American Journal of Gastroenterology titled “Anal Intercourse and Fecal ...

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The United States Preventive Services Task Force (USPSTF) was created by the federal government in 1984 to provide recommendations to primary care practitioners on the scientific efficacy of screening. In 2010, the federal government linked USPSTF recommendations with national healthcare policy when the Affordable Care Act mandated free coverage by Medicare and private insurance for all screening exams that receive a USPSTF recommendation of A or B.  The ...

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It’s still flu season, although the flu gods have shown a bit more mercy than in years past.  So many variables determine whether each winter brings a relatively mild flu season, a “flunami,” or something in between.  I’m a country boy doing primary care in the city, and I have only a modest understanding of which influenza strain is circulating, the concepts of antigenic drift and shift, and how the ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 53-year-old woman is evaluated for a slowly enlarging, telangiectatic, pearly, ulcerated 1-cm plaque on the left temple. It bleeds periodically when traumatized. Medical history is significant for atrial fibrillation. She takes warfarin daily. She is otherwise in good health. On physical examination, vital signs are normal. Cardiac examination shows an irregular heart ...

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The Zika virus in the news these days reminds us of another microcephaly-causing virus which scourged our world in the not-so-distant past. In the years right before we were born (the late 1960s), the virus rubella routinely swept through the United States and the rest of the world. The airborne germ rubella, just like the Zika virus, caused most people just a mild illness that they usually never even knew that they ...

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Potential patients -- usually parents -- occasionally ask me if I am "vaccine-friendly." After having this question posed to me numerous times, I’m prepared for the conversation that follows. I’ve tried to ease into it in various ways, but none has proven universally comfortable. The question's phrasing is telling about a person's perspective. It implies that their previous experiences with physicians were perceived as "unfriendly." Also, my defensive side infers it ...

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It is easy to lose oneself while swimming in a sea of medical facts surrounded by overburdened physicians and high-acuity cases. Initially, it is difficult taking care of one patient, much less a whole service. The transition from student to student-doctor is not as homophonic as the semantics would suggest -- and this transition affects the mental health of thousands of medical students each year. Medicine is less a profession and ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 42-year-old woman is evaluated for episodes of palpitations that last several seconds in duration. They occur once or twice a month and are accompanied by lightheadedness and mild dyspnea. She has not experienced loss of consciousness. The episodes are not precipitated by any particular activity, including exercise. She takes no medications. On ...

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